Arkansas currently ranks 48th among 52 in its performance of the 24 CMS quality indicators of care. CMS quality reports show the three top conditions impacted by these quality indicators in Arkansas are community-acquired pneumonia, congestive heart failure, and acute myocardial infarction. The top conditions at St. Bernards Medical Center (SBMC), in Jonesboro, Arkansas, are the same. Furthermore, SBMC admits more patients with these three conditions than any other health care facility throughout Arkansas. With this project, SBMC, a group of 20 physicians practicing in 11 outpatient clinics, a group of 240 physicians, and a university will work together to improve health care for people living in Jonesboro and the surrounding 23-county area in the rural Arkansas Delta. The project aims to improve quality of care and patient safety and to do so in a prudent, efficient, and cost-effective manner through a collaborative team approach. To make this possible, Misys Pharmacy(TM) and Misys Insight(TM) will be implemented in both inpatient and outpatient settings, including several rural clinics. It will take advantage of a preexisting IT system linking the medical center to the clinics. The project includes a training component for 260 physicians, 1,000 front-line clinicians, and 257 students in nursing and other health professions. It also includes a hospital pharmacy component. Clinical pharmacy needs to evolve and become more consistent in the provision of the core set of services--primarily ADE management/prevention and drug protocol management. Measuring quality improvement and comparing data constitute the vital third component. An innovative feature is the Misys Insighttm Training Module, which students will access through a secure Internet connection to the medical center. These efforts will lay the foundation for decreasing the morbidity and mortality rates among patients with the three aforesaid conditions in the 23-county targeted service area. With this foundation in place, the partners will be positioned to efficiently and effectively address the remaining CMS quality indicators.